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两种含屈螺酮的低剂量复方口服避孕药对年轻育龄女性骨转换和骨密度的影响:一项前瞻性对照随机研究。

Effects of two low-dose combined oral contraceptives containing drospirenone on bone turnover and bone mineral density in young fertile women: a prospective controlled randomized study.

作者信息

Gargano Virginia, Massaro Mariangela, Morra Ilaria, Formisano Carmen, Di Carlo Costantino, Nappi Carmine

机构信息

Department of Gynecology and Obstetrics, University of Naples Federico II, 80131 Naples, Italy.

出版信息

Contraception. 2008 Jul;78(1):10-5. doi: 10.1016/j.contraception.2008.01.016. Epub 2008 May 27.

Abstract

BACKGROUND

The effects of a 21-day combined oral contraceptive containing 30 mcg ethinyl estradiol plus 3 mg drospirenone with a 21-day preparation containing 20 mcg ethinyl estradiol plus 3 mg drospirenone on bone turnover and bone mineral density (BMD) in young fertile women were compared.

METHODS

A randomized, controlled trial was conducted on healthy fertile women treated with 30 mcg ethinyl estradiol plus 3 mg drospirenone (Group A; n=21), 20 mcg ethinyl estradiol plus 3 mg drospirenone (Group B; n=23) and healthy controls (Group C; n=21). At 3, 6, 9 and 12 months, serum and urinary calcium, osteocalcin (BGP), urinary pyridinoline and deoxypyridinoline were measured. At baseline and after 12 months, lumbar bone mineral density was determined by dual-energy X-ray absorptiometry.

RESULTS

In Groups A and B, urinary pyridinoline and deoxypyridinoline at 6, 9 and 12 months were significantly reduced in comparison with basal values and Group C (p<.05). In Groups A and B, serum calcium levels were significantly increased after 6 months. No significant difference was detected between Groups A and B in urinary levels of pyridinoline and deoxypyridinoline, in calcium levels and in BGP levels. At 12 months, no significant difference was detected in spinal BMD values between the three groups and in comparison with basal values.

CONCLUSION

Both combined oral contraceptives exert a similar positive influence on bone turnover in young postadolescent women.

摘要

背景

比较了含30微克炔雌醇加3毫克屈螺酮的21天复方口服避孕药与含20微克炔雌醇加3毫克屈螺酮的21天制剂对年轻育龄妇女骨转换和骨矿物质密度(BMD)的影响。

方法

对健康育龄妇女进行随机对照试验,这些妇女分别接受30微克炔雌醇加3毫克屈螺酮治疗(A组;n = 21)、20微克炔雌醇加3毫克屈螺酮治疗(B组;n = 23)以及健康对照(C组;n = 21)。在3、6、9和12个月时,测量血清和尿钙、骨钙素(BGP)、尿吡啶啉和脱氧吡啶啉。在基线和12个月后,通过双能X线吸收法测定腰椎骨矿物质密度。

结果

在A组和B组中,6、9和12个月时的尿吡啶啉和脱氧吡啶啉与基础值及C组相比显著降低(p<0.05)。在A组和B组中,6个月后血清钙水平显著升高。A组和B组在尿吡啶啉和脱氧吡啶啉水平、钙水平及BGP水平方面未检测到显著差异。12个月时,三组之间的脊柱骨密度值与基础值相比未检测到显著差异。

结论

两种复方口服避孕药对年轻青春期后妇女的骨转换均产生相似的积极影响。

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